Pay

<table id="payment-table"><!-- [et_pb_line_break_holder] --> <tr><td>Child’s Name:</td><td></td><td><input id="child-name" type="text" style="width:200px;"></input></td></tr><!-- [et_pb_line_break_holder] --> <tr><td>School:</td><td></td><td><input id="school" type="text" style="width:200px;"></input></td></tr><!-- [et_pb_line_break_holder] --> <tr><td>Invoice Amount:</td><td>$</td><td><input id="invoice-amount" type="text" style="width:80px;" onch2ange="calculateSurcharge()"></input></td></tr><!-- [et_pb_line_break_holder] --> <tr><td>With Surcharge:</td><td>$</td><td style="padding-left:4px;"><span id="payment-amount"></span></td></tr><!-- [et_pb_line_break_holder] --> <tr><td colspan="3"><span class="footnote"></span></td></tr><!-- [et_pb_line_break_holder] --> <tr><td colspan="3" style="text-align:center;padding-top:20px;"><input type="button" value="Pay Now" style="-webkit-appearance:button;font-size:150%;" onclick="payNow()"></input></td></tr><!-- [et_pb_line_break_holder] --> </table><!-- [et_pb_line_break_holder] --> <form id="payment-form" method="post" target="_blank" action="https://www.ipg.stgeorge.com.au/StgWeb/servlet/webpay.website.Simple?token1=8ywmgV2ibRilEs3U0yCbvvRv2&token2=o2OIJkzvmZUOkeGMwKvep5MGd"><!-- [et_pb_line_break_holder] --> <input id="description-hidden" name="description" type="hidden"></input><!-- [et_pb_line_break_holder] --> <input id="payment-amount-hidden" name="amount" type="hidden"></input><!-- [et_pb_line_break_holder] --> </form><!-- [et_pb_line_break_holder] -->